Dialysis is a separation and purification technique that separates small molecules from biological macromolecules through the principle of diffusion of small molecules through semi-permeable membranes to buffers. Patients with chronic kidney disease, the results can not control the disease, will eventually find that to the end-stage renal disease or renal failure, that is, the stage of uremia, we often say that they must maintain life through kidney transplantation or dialysis. So, people with bad kidneys, to what extent, the disease needs to start dialysis? Can dialysis save kidney function? What do I need to be aware of? Let's solve your doubts now.
As we all know, the main function of the kidneys is to generate urine, excrete metabolic waste, and maintain water and electrolyte balance. If kidney disease develops to the stage of uremia, kidney function is seriously insufficient, the amount of urine is reduced to 400 ml per day, or even 100 ml, water and electrolyte metabolism are basically stopped, the basic structure of the kidney is destroyed, urea nitrogen, as well as creatinine and metabolic waste can not be excreted in time, trapped in the blood, it will cause serious damage to important organs. The role of dialysis is to replace the work of the kidneys and maintain the basic functional needs of the body's survival. Therefore, dialysis is a life-saving treatment, when the structure and function of the kidneys are seriously damaged, it is necessary to undergo dialysis treatment if the kidneys cannot be replaced. This treatment only sustains life and replaces the function of the kidneys, however, it is impossible to save the kidney function that has been impaired.
Dialysis, the method currently used, mainly has 2 categories, hemodialysis and peritoneal dialysis. Hemodialysis, a wide range of application, there are no absolute contraindications, but in special cases, it needs to be used with caution, for example, there is intracranial hemorrhage or increased intracranial pressure, shock or hypotension, serious heart failure caused by myocardial lesions and pulmonary edema, malignant tumors, mental disorders can not be combined with treatment. Peritoneal dialysis is suitable for the elderly or children, as well as those with serious chronic diseases, residual kidney function is still good, and have home treatment conditions. However, there are contraindications to peritoneal dialysis, such as peritoneal incompleteness or fibrosis, severe skin diseases, and mental disorders. Peritoneal dialysis is prudent in the presence of celiac lesions or ischemic bowel disease, systemic vascular lesions, severe disc disease, and chronic obstructive emphysema.
Dialysis treatment can improve uremia symptoms, stabilize the condition, and improve the quality of life. The 2 main methods are compared, with their own characteristics. Hemodialysis, which is more efficient in the removal of water and toxins, has the disadvantage of requiring treatment at dialysis centers, in addition, complications are more affected, and sometimes hospitalization is required. The technical requirements for peritoneal dialysis are relatively simple, trained, can be performed in the family, have a lower cost and less complications. The disadvantage is that the clearance efficiency is low, and excessive glucose absorption may cause or worsen hyperglycemia and hyperlipidemia.
An important advance in dialysis therapy is the application of wearable artificial kidney WAK, including hemodialysis instruments, peritoneal dialysis instruments, and instruments with both hemodialysis and peritoneal dialysis functions. The wearable artificial kidney, which can operate around the clock like a normal kidney, can better control blood pressure and weight, reduce the burden on the heart, and improve the clearance of blood toxins. At present, ready to enter the official use of wearable artificial kidneys, weighing less than 1 kg, can be charged at night, the use of this device, can relax the diet control conditions, patients can work normally, control the condition, improve the quality of life.
After dialysis treatment begins, it cannot be stopped at will, otherwise, it may cause tubular paralysis, resulting in more accumulation of toxins, aggravating the condition, and even dying soon. Patients undergoing dialysis treatment need to focus on 3 problems, tumors, infections, and cardiovascular and cerebrovascular diseases. Studies have shown that patients with uremia have a malignant tumor incidence, which is 7 times that of ordinary people, a higher incidence of tumors in dialysis patients, a higher incidence of tumors in hemodialysis patients, genitourinary system tumors, and a higher incidence of lung cancer in peritoneal dialysis patients. In patients undergoing long-term hemodialysis, the rate of lung infection exceeds 50%. In addition, the risk of myocardial infarction, heart failure, stroke and other cardiovascular and cerebrovascular accidents will also increase significantly.
Patients receiving dialysis treatment need strict dietary coordination, focusing on managing water and salt intake, maintaining balance, and need to decide on the amount of water to replenish according to the amount of urine, water loss, dialysis water removal, etc., and pay close attention to weight changes. Salt intake, which requires strict management, is 3 grams of salt intake per day for patients who are dialyzed 2 times a week, and 4 grams of salt intake per day for patients who are dialyzed 3 times a week. In addition, potassium intake should be strictly limited to prevent the occurrence of hyperkalemia. Protein intake, calculated at 11 grams per kilogram of body weight, prevents excessive protein intake from aggravating azotemia.
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